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Just Beginning Taper, Bead Counting Advice?


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#1 me1issa

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Posted 21 August 2019 - 07:18 PM

Hi everyone!

 

I'm Melissa, I'm a 30 year old woman and I was prescribed Cymbalta for pain management (I've been taking the generic drug). I started it July 10. I was on 20mg for 2 weeks, then upped to 40 mg for 2 weeks, then upped to 60mg. It hasn't been helping at all, so my doctor and I decided it's time to discontinue this and try a different medication. 

 

I had no idea that the withdrawal symptoms could be so horrific until she cautioned me about tapering off and I did some reading on my own. I kind of wish I hadn't gone down that rabbit hole, because now I'm super anxious and scared of coming off of it.

 

My dr's instructions were to drop to 40mg for 1 week, and then 20mg for another week, and then stop. After what I've read, this seems super abrupt.

 

I understand that 20mg is the smallest dose, but I've also seen a lot of people discussing bead counting. I was wondering if someone could give me some advice on how to do that? I know you take the beads out and divide them in half, but how do I open the capsule, and how do I put it back together? How many beads should I expect to be in there? Should I drop to 10mg, and then to 5, etc., or do it even slower than that? 

 

Today was my first day of dropping from 60 to 40 mg and honestly I feel SO much better physically, the general malaise is greatly reduced, but I also understand that sometimes symptoms can take a few days to kick in.

 

Thank you SO much for your help. :)


#2 invalidusername

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Posted 21 August 2019 - 08:43 PM

Hi Melissa and welcome to the forum.
 
Whilst we are clearly not advocates of Cymbalta on this site, I am compelled to say that the benefits of ANY antidepressant would not be known at such an early stage. These drugs need at least 8 weeks for the better days to kick in... and when you change the dose during this initial time, you need at add another 2 weeks to this time. 
 
The only circumstances whereby a quick exit is used, is when the side-effects are too much to cope with, otherwise, you do need to give these drugs a fair trial. I am not saying that Cymbalta will have worked for you, but after 5 weeks, and after 2 changes in dose, we are still looking at very early days.
 
However, you have come to us for withdrawal advice... so... your first drop does sound promising, but it will take around 3 days for blood levels to balance, at which point, the withdrawal effects will kick in - if there are to be any. You may find that you are quite stable until the 20mg mark, but from that point, I would suggest you count beads from there. Again, you may be one of the fortunate ones who can cold turkey from 20mg with minimal problems, but you are right to err on the side of caution.
 
I also assume that you will not be changing to another anti-depressant, otherwise a cross-taper would be a better way to go. But as most, other than Cymbalta, are not used for pain management, I assume you are changing to a different group of meds and therefore need to taper off the Cymbalta. 
 
So to open a capsule, lightly take each end of the capsule and pull and twist and the capsule will open. To close, just push together and it will snap closed. After your week at 20mg I would remove 10% of the beads every couple of days for a further week, and then when you are at 30% of the remainder, drop to 5%, thus taking a further 6 days to finish. If this needs more detail please let me know! The amount of beads in the capsule can vary, but will be in the 100's, so patience is required for this counting!!
 
IUN

#3 me1issa

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Posted 21 August 2019 - 09:38 PM

Thank you SO much for such a fast and detailed response!

Without getting too graphic, this is a very specific type of pain, and the doc thinks that I'd be feeling some sort of improvement by now. All I've got is insomnia. :P But honestly, now that I see how bad the withdrawal can be, I want to come off it anyway. I don't think I would have started it if I had been aware. And, yes, we'll be trying a different type of medication, so the cross-taper wasn't something she had mentioned.

I really, really appreciate your advice. I think I understand what you're saying. Do my week of 40mg. Then my week of 20mg, then a week of dropping by 10% each day, then drop by 5% each day for the remainder? I'm SO okay with being patient and doing lots of math if it means avoiding the awful things I've read.

#4 fishinghat

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Posted 22 August 2019 - 07:58 AM

Welcome Me1issa

 

IUN has got you off to a good start. Be aware that many times those who took Cymbalta for pain experience what is called rebound pain, a sharp increase in their pain, which will fade with the fading of the withdrawal.


#5 me1issa

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Posted 22 August 2019 - 08:11 AM

Oh, that's very good to know, thank you for the heads up! 


#6 invalidusername

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Posted 22 August 2019 - 11:57 AM

Under the circumstances, I am glad you are stopping - I think it is the best thing to do.


#7 me1issa

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Posted 22 August 2019 - 12:53 PM

Thank you for the advice and the validation. I'll update how it's going. Still so far, so good on 40mg.

#8 me1issa

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Posted 28 August 2019 - 12:23 PM

Okay, I got through my week of 40mg! 

Today is the first day of the 20mg dose. 

So far, so good. Nothing really to report except some occasional nausea here and there, but that could also be from all the anxiety I've been having about it. 

Trying to remember to breathe - I've got a chunk of this out of the way. :)


#9 fishinghat

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Posted 28 August 2019 - 01:05 PM

That is a big drop but so glad all is well so far. The digestive issues are the first to raise their ugly heads so be patient before dropping anymore.

#10 invalidusername

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Posted 28 August 2019 - 02:49 PM

Woh! 50% drop!! Holy moly Melissa!

 

Hope you do well - 3 to 4 days after will be the point to hold for. If you can get past this, you should be able to breathe a bit. But needs must as you say from your symptoms.

 

Thanks for the update - keep us posted.


#11 me1issa

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Posted 30 August 2019 - 11:35 AM

Thank you so much for the support!! 

 

I know this is a big drop, but it was what the doctor recommended, so I figured I would give it a shot since I've been feeling okay. And I'm still feeling okay. I have a gnarly headache today but that could be some cycle-related garbage because that's pretty par for the course. We'll see how I feel tomorrow and Sunday. :)


#12 invalidusername

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Posted 30 August 2019 - 03:48 PM

Sounds promising...


#13 me1issa

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Posted 09 September 2019 - 03:18 AM

Hey guys! Just wanted to check in. I am currently almost through my week of reducing by 10% each day! And it has been going well so far, so thank you so so much for that suggestion. On Wednesday I will reach 30% of beads remaining and drop back to 5% reductions and so I don't have much further to go! It felt like it was going to be forever at the beginning, but this slow taper is working for me. I'm having some nightmares and sleep interruptions. And more frequent headaches and intermittent nausea here and there, but nothing I can't handle. So ready for the final stretch.

#14 invalidusername

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Posted 09 September 2019 - 06:49 AM

Thanks for the update me1issa and it really sounds like you are doing well - but absolutely make sure you do go to those 5% as the last part can really turn the tables. The sleep, headaches and nausea is all par for the course - ginger is a very good aid for keeping nausea in check if you aren't already using it. I found buying ginger root and making tea helps a lot. You can buy ginger tea already made of course, but I found a stronger potency was better and was cheaper to buy root ginger than using 5 teabags!


#15 fishinghat

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Posted 09 September 2019 - 09:05 AM

During the 5% drops be sure and be ready to stop if things get too bad. Don't wait until you feel terrible to stop. At the first sign of things getting worse you can stop until stable and then wean a slower if necessary. Lets hope that all goes well.

#16 invalidusername

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Posted 09 September 2019 - 09:18 AM

Sage advice from Hat. It is so easy to get complaisant with these things. 


#17 me1issa

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Posted 09 September 2019 - 11:08 AM

Thank you again, so much. I do have dried ginger that I have just been eating and ginger ale and they definitely do help a lot! 

I promise not to be stubborn and to take it as slow as I can with this last bit. You guys have been invaluable, I can't thank you enough for the support. Family and friends think I'm being dramatic about doing this so slowly but I just want to play it as safe as possible 


#18 invalidusername

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Posted 09 September 2019 - 01:48 PM

....and very wise you are to do so. 

 

Stop by as often as you wish my dear. We all understand what you are going through.


#19 me1issa

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Posted 11 September 2019 - 10:18 AM

So, I checked in with my doctor this morning and she had said that even though I am not switching to a different medication at this time, if I want, she would prescribe Prozac for me to help me taper off the Cymbalta, at the very least to ease my anxiety about withdrawal. She said that it would be up to me, that I could go onto the Prozac to finish off the Cymbalta and then also taper off the Prozac by taking it by itself for an additional week, and then every other day for another week, and then stopping. 

 

Honestly, I've seen some of the best information about this here, not from her - could you explain to me how this helps? Also she said the decision is up to me and she will call in the Prozac if I want her to, do you think that it would help even though I'm not switching to something else and would have to then wean off the Prozac anyway? 


#20 fishinghat

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Posted 11 September 2019 - 01:40 PM

I have nothing against Prozac to get off Cymbalta but 6 to 8 weeks to kick in is a long time. Also Prozac like all antidepressants work for some but not others. I went to Prozac for 8 weeks and it did nothing but other members have had success.

Cymbalta helps regulate serotonin and norepinephrine in the brain. Both are neurotransmitters. When you brain has the Cymbalta removed then it must adjust to controlling these neurotransmitters itself. By adding an ssri like Prozac (which helps regulate serotonin) it gives some relief to the burden put on the brain in trying to adapt.

#21 invalidusername

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Posted 11 September 2019 - 04:10 PM

Agree with Hat, but bearing in mind that they are two different classes of drug (SSRI/SNRI), so it won't be a complete solution to your withdrawal woes.

 

I personally feel it is too much of a risk and would go for the supplement route. Prozac may work in some cases, but it is adding more work for your brain to cope with and if it doesn't work, you are pouring more fuel on the fire. I would call it an absolutely last resort. Most people who do it, begin cross tapering early so they know in advance if there is going to be any success in taking it before the last few beads hit. 

 

Up to you, and we will support you either way you wish to proceed, but you are the one to make the decision...


#22 me1issa

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Posted 11 September 2019 - 07:16 PM

Okay, thank you for the information! I wasn't sure how I felt about throwing another drug into the mix when I'm this close, so I will probably just ride it out and hope for the best.


#23 invalidusername

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Posted 11 September 2019 - 07:35 PM

Wise move I think. Keep us posted...


#24 me1issa

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Posted 17 September 2019 - 06:20 PM

Hey guys! Just an update. I'm now down to my last week. My last day should be Monday. I stretched an extra few days so I can drop even slower at the end. I'm still getting some dull headaches and nausea intermittently but I'm doing okay! 

 

I've noticed in the very early morning, I get a weird tingling at the base of my skull that creeps forward slowly and stops around my hairline. It lingers and fades out gradually. It only happens once, and only if I wake up early (4am or so, which is my usual). If I go back to sleep and wake up even just an hour later, I'm fine. 


#25 fishinghat

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Posted 18 September 2019 - 08:39 AM

Looking promising. That is good news.


#26 invalidusername

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Posted 18 September 2019 - 05:06 PM

Sounds good. Re the head thing, I remember getting a sort of effervescing feeling on my scalp which came and went during withdrawal - you do get some odd stuff happen! 


#27 me1issa

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Posted 23 September 2019 - 05:08 AM

Today's my last day! One bead left for this morning. Still hanging in. Occasional weird scalp tinglies but only in the mornings, some nightmares but nothing too abnormal, intermittent nausea, a little erratic mood swinging from crying to super angry but nothing I can't manage. Fingees crossed for the rest of this week! If i stay on this level I've totally got this.

#28 invalidusername

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Posted 23 September 2019 - 08:40 AM

Fantastic - well done for getting to this point. As you say, let's just hope this status quo you have going continues. 

 

Please keep in touch with the details!


#29 me1issa

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Posted 25 September 2019 - 05:53 AM

Well, I've been really tired and REALLY sweaty. Sometimes I get a weird, sharp itchiness on my skin in random places. But still nothing completely intolerable!

#30 invalidusername

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Posted 25 September 2019 - 07:40 AM

I remember the sweats - particularly at night. Too cold to sleep without blanket and too uncomfortable to sleep with...!

 

Keep going - you are doing really well.





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